Urs Aadithya B, Singh Hanspal, Nunia Kalpana, Mohanty Sujata, Gupta Shalini
MDS, Professor & Head, Department of Oral & Maxillofacial Pathology,Maulana Azad Institute of Dental Sciences, New Delhi, India, BSZ Marg, New Delhi-110002.
MDS, Senior Resident, Department of Oral & Maxillofacial Pathology, Maulana Azad Institute of Dental Sciences, New Delhi, India, BSZ Marg, New Delhi-110002.
J Clin Exp Dent. 2015 Oct 1;7(4):e535-9. doi: 10.4317/jced.52247. eCollection 2015 Oct.
Non-invasive aspergillosis in immunocompetent individuals subsequent to post endodontic treatment can involve the maxillary antrum. An early and accurate diagnosis will aid in prompt and effective treatment. A 35 year old female patient reported with a painful nasomaxillary swelling. Previous records revealed the failure of the endodontic treatment of maxillary left second premolar which was subsequently extracted. Root piece was accidently left behind which resulted in a painful nasomaxillary swelling. The extraction socket was curetted and tissue was sent for histopathological examination, which revealed abundant septate fungal hyphae with numerous spores characteristic of Aspergillus. The patient showed marked improvement in the symptoms with systemic itraconazole at 3 months follow up and complete resolution occurred within 6 months. Inclusion of aspergilloma infections in the differential diagnosis is advocated when patients present with post-endodontic nasomaxillary swelling.
Aspergillosis, fungal sinusitis, post root canal treatment.
免疫功能正常个体在根管治疗后发生的非侵袭性曲霉病可累及上颌窦。早期准确的诊断将有助于及时有效的治疗。一名35岁女性患者报告有疼痛性鼻上颌肿胀。既往记录显示上颌左侧第二前磨牙根管治疗失败,随后拔除。牙根碎片意外遗留,导致疼痛性鼻上颌肿胀。对拔牙窝进行刮治,并将组织送去做组织病理学检查,结果显示有大量具隔真菌菌丝以及许多曲霉菌特征性的孢子。在3个月的随访中,患者使用全身性伊曲康唑后症状明显改善,6个月内症状完全消退。当患者出现根管治疗后鼻上颌肿胀时,提倡将曲菌球感染纳入鉴别诊断。
曲霉病;真菌性鼻窦炎;根管治疗后